A total of 265 people have come forward to say they were abused by disgraced Olympics doctor Larry Nassar, according to a judge.
More than 150 victims gave statements throughout his sentencing hearing last week, during which a judge jailed him for between 40 and 175 years.
Scores of other women are expected to speak over the next few days during his third hearing for molesting gymnasts at an elite Michigan club run by Olympic coach John Geddert.
Nassar has admitted to sexually abusing three girls under the guise of treatment.
He faces a sentence of at least 25 years in prison on top of the sentences he has been handed, including 60 years for possession of child abuse images.
His third hearing comes after the USA Gymnastics board of directors were told they must all resign or face termination proceedings.
All the directors agreed to resign and the organisation announced on Wednesday that the last remaining directors had stood down.
During Wednesday's hearing, victim Jessica Thomashow, 17, was the first to confront the former doctor. She told the court she had been abused by him when she was nine years old.
She told him what he did to her was "twisted" before simply asking "why?"
Ms Thomashow said: "You took advantage of my innocence and trust.
"You were my doctor. Why? I ask myself that question all the time. You manipulated me and my entire family. How dare you."
She added: "Larry Nassar preyed on us for his own pleasure, leaving in his wake traumatised and broken girls."
Annie Labrie, another victim, also testified against the doctor, saying he did things to her that "made [her] skin crawl".
She added that activities like gymnastics and dance had a culture that allows abuse to thrive.
A third victim, Katherine Ebert, said: "You are most vile, disgusting creature I have ever met.
"There are black holes in my memory that come back as nightmares or flashbacks, not wanting to believe they're true."
During the hearing in Charlotte, Michigan, Nassar will hear from around 60 women who say they were abused by him.
Judge Janice Cunningham said: "We have over 265 identified victims and an infinite number of victims in the state, in the country, and all over the world.
"As a result, by allowing live streaming and tweeting, all individuals are able to participate in this process."
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Following the resignation of all its directors, USA Gymnastics said it will "hold the organisation to the highest standards of care and safety in further developing a culture of empowerment for our athletes and members."
The president of Michigan State University, Lou Anna Simon, also resigned over the Nassar scandal. She was replaced by former Michigan governor John Engler, who will take over as interim leader.